To date, Endoscopic Retrograde Cholangiopancreatography (ERCP) still remains the standard of reference among different imaging techniques investigating biliary and pancreatic pathologies [1, 2]. In recent years, imaging techniques alternative to ERCP have been developed, such as Endoscopic Ultrasonography (EUS) and Magnetic Resonance Cholangiopancreatography (MRCP). Since its first clinical application in 1991 [3], MRCP has been proven to be a safe and non-invasive imaging method, without exposing the patient to ionizing radiation and avoiding the complications intrinsic of invasive procedures. For the three over-mentioned techniques (i.e., MRCP, EUS, and ERCP) a comparable high diagnostic accuracy in the evaluation of bile and pancreatic ducts has been demonstrated [4], thus leading to candidate MRCP as the new standard of reference, at least for bile duct abnormalities [5]. MRCP has also shown to be useful in liver-transplanted patients, providing valuable diagnoses of biliary complications [6, 7, 8, 9, 10]. Nevertheless, to our knowledge, only a few studies investigated the effective clinical impact of MRCP on patients’ management [11, 12, 13 ,14, 15], and no studies were conducted on liver-transplanted patients. As a consequence, if MRCP really determines a reduction of ERCPs performed for diagnostic purposes in clinical practice is still under debate. The purpose of our study was therefore to assess the role of MRCP in the clinical decision-making process of referring physicians, by determining the diagnostic yield, the diagnostic thinking efficacy and the therapeutic efficacy.
Impact of magnetic resonance cholangiopancreatography (MRCP) in patients’ management: Preliminary results of a clinical decision-making study
Cereser L;GIROMETTI, Rossano;ZUIANI, Chiara;
2010-01-01
Abstract
To date, Endoscopic Retrograde Cholangiopancreatography (ERCP) still remains the standard of reference among different imaging techniques investigating biliary and pancreatic pathologies [1, 2]. In recent years, imaging techniques alternative to ERCP have been developed, such as Endoscopic Ultrasonography (EUS) and Magnetic Resonance Cholangiopancreatography (MRCP). Since its first clinical application in 1991 [3], MRCP has been proven to be a safe and non-invasive imaging method, without exposing the patient to ionizing radiation and avoiding the complications intrinsic of invasive procedures. For the three over-mentioned techniques (i.e., MRCP, EUS, and ERCP) a comparable high diagnostic accuracy in the evaluation of bile and pancreatic ducts has been demonstrated [4], thus leading to candidate MRCP as the new standard of reference, at least for bile duct abnormalities [5]. MRCP has also shown to be useful in liver-transplanted patients, providing valuable diagnoses of biliary complications [6, 7, 8, 9, 10]. Nevertheless, to our knowledge, only a few studies investigated the effective clinical impact of MRCP on patients’ management [11, 12, 13 ,14, 15], and no studies were conducted on liver-transplanted patients. As a consequence, if MRCP really determines a reduction of ERCPs performed for diagnostic purposes in clinical practice is still under debate. The purpose of our study was therefore to assess the role of MRCP in the clinical decision-making process of referring physicians, by determining the diagnostic yield, the diagnostic thinking efficacy and the therapeutic efficacy.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
